Ureter: Pelvic Part

Question 1

Course

Answer 1

1. Enters pelvis at common iliac artery bifurcation
2. Runs downwards and slightly backwards along internal iliac artery lower border
3. At ischial spine level, it curves forwards & medial (in female it runs below broad ligament root)
4. Enters urinary bladder posterosuperior angle
5. Passes obliquely downwards and medial for 2 cm in its wall (intramural part) to open in trigone upper lateral angle
6. This obliquity provides a valve like mechanism that prevents urine reflux into ureter when bladder is distended

Question 2

Relations: medial

Answer 2

Covered by peritoneum

Question 3

Relations: lateral

Answer 3

Crosses:
1. External iliac artery and vein
2. Obturator nerve, artery, and vein
From above downwards

Question 4

Ureter: male

Answer 4

1. It is crossed by vas deferens near bladder wall
2. Here it crosses seminal vesicle upper end

Question 5

Ureter: female

Answer 5

1. Closely lateral to vagina upper end below broad ligament root
2. Here it is crossed by uterine artery

Question 6

Arterial supply in male

Answer 6

Inferior vesical artery

Question 7

Arterial supply in females

Answer 7

Vaginal and uterine arteries

Question 8

Nerve supply

Answer 8

Sympathetic:
1. Lower thoracic spinal segments
2. 1st lumbar spinal segment
Parasympathetic:
1. 2nd to 4th sacral spinal segments

Question 9

Applied anatomy: ureteric colic

Answer 9

1. Pain referred to cutaneous areas innervated from the same spinal cord segments that supply ureter
2. Pain commences in loin and shoots downwards to groin and scrotum or labia major
3. It may extend to upper part of thigh front along area supplied by genitofemoral nerve